Dehydrated Alcohol
NDC Package 62250-105-15

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Other Packages
    3. Frequently Asked Questions

Package Information

This product is EXCLUDED from the official NDC directory because the listing data was inactivated by the FDA.

Dehydrated Alcohol is aBLYSINOL® is indicated to induce controlled cardiac septal infarction to improve exercise capacity in adults with symptomatic hypertrophic obstructive cardiomyopathy who are not candidates for surgical myectomy. Marketed by Belcher Pharmaceuticals, Llc, this product is identified by NDC 62250-105 and is authorized under FDA application NDA207987.

Identification & Billing

NDC Package Code
62250-105-15
Package Description
10 AMPULE in 1 CARTON / 5 mL in 1 AMPULE (62250-105-02)
Product Code
62250-105
11-Digit Billing Format
62250010515
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Dehydrated Alcohol
Dosage Form
-
Usage Information
ABLYSINOL® is indicated to induce controlled cardiac septal infarction to improve exercise capacity in adults with symptomatic hypertrophic obstructive cardiomyopathy who are not candidates for surgical myectomy.

Regulatory & Marketing

Labeler Name
Belcher Pharmaceuticals, Llc
FDA Application #
NDA207987
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
07-02-2018
Listing Expiration
12-31-2022
Exclude Flag
I
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Other Available Packages

The following commercial packages are registered under the same Product NDC (62250-105). Click a package code to view its specific billing and regulatory data.

62250-105-10
10 AMPULE in 1 CARTON / 1 mL in 1 AMPULE (62250-105-01)

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 62250-105-15 identifies a specific commercial package of 10 ampule in 1 carton / 5 ml in 1 ampule (62250-105-02) of Dehydrated Alcohol, labeled by Belcher Pharmaceuticals, Llc. This is formulated for use and contains as the active substance.

Is this product currently listed with the FDA?

This product code is currently listed as inactive or excluded from the primary directory. It was introduced to the market by Belcher Pharmaceuticals, Llc on July 02, 2018. The current certification is valid through December 31, 2022.

How is this Belcher Pharmaceuticals, Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 62250010515. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (5-3-2)
62250-105-15
11-Digit CMS (5-4-2)
62250-0105-15

Note: The zero is added to the Product segment to maintain the 5-4-2 structure.